The physician declares after delivering the placenta of a client during a cesarean section that it appears that the client has a placenta accreta. Which of the following maternal complications would be consistent with this diagnosis?

Correct Answer: A

Rationale: In the scenario described, the correct answer is A) Blood loss of 2,000 mL. Placenta accreta is a condition where the placenta attaches too deeply into the uterine wall. During delivery, separating the placenta can lead to severe bleeding as the placenta cannot detach properly. This can result in significant blood loss, which is a common complication associated with placenta accreta. Option B) Blood pressure of 160/110 is not directly related to placenta accreta but could indicate hypertension, which is a different condition. Option C) Jaundiced skin color is not typically associated with placenta accreta. Jaundice usually occurs due to liver or bile duct issues, not directly related to placental attachment abnormalities. Option D) Shortened prothrombin time is not a common complication of placenta accreta. Prothrombin time measures how long it takes for blood to clot, and in placenta accreta, the main concern is excessive bleeding rather than clotting abnormalities. Understanding the maternal complications of placenta accreta is crucial for healthcare providers managing postpartum care. Recognizing the signs and symptoms can aid in prompt diagnosis and appropriate management to prevent severe maternal outcomes. It is essential for healthcare professionals to be well-versed in these complications to ensure the best possible care for their patients during the postpartum period.

Correct Answer: B

Rationale: In the postpartum period, especially in the presence of deep vein thrombosis (DVT), the client is at high risk for a stroke. This is because DVT can lead to the formation of blood clots that can travel to the brain, causing a stroke. Option A, hemorrhage, is less likely as DVT is associated with clot formation rather than excessive bleeding. Option C, endometritis, is more commonly associated with postpartum infections rather than DVT. Option D, hematoma, is a localized collection of blood outside of blood vessels and is not directly related to the complications of DVT. Educationally, understanding these postpartum hormonal changes and associated risks is crucial for healthcare providers to provide appropriate care and interventions to prevent serious complications like stroke in postpartum clients with DVT. It highlights the importance of thorough assessment, monitoring, and early intervention in managing postpartum complications.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Benadryl (diphenhydramine). The client's symptoms of pruritus and macular rash are indicative of an allergic reaction, which is a common side effect of spinal anesthesia. Benadryl is an antihistamine that can help alleviate these symptoms by blocking the histamine response responsible for the itching and rash. Option A) Reglan (metoclopramide) is used to treat nausea and vomiting, which are not the primary symptoms presented by the client. Option B) Zofran (ondansetron) is also used for nausea and vomiting, not pruritus or rash. Option C) Compazine (prochlorperazine) is an antiemetic used for nausea and vomiting, not allergic reactions like pruritus and rash. In an educational context, understanding the side effects and appropriate interventions for common medications used in the postpartum period is crucial for nurses caring for maternal clients. Recognizing and managing allergic reactions promptly is essential to ensure the well-being and comfort of the client. Diphenhydramine is a commonly used antihistamine in such situations, making it a valuable medication to have knowledge about in the postpartum setting.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Mastitis. Mastitis is an infection of the breast tissue that can occur due to various factors, including retained placental fragments. In this case, the retained placental fragments can lead to an infection, causing inflammation and pain in the affected breast. Common symptoms of mastitis include redness, warmth, swelling, and tenderness in the breast, accompanied by flu-like symptoms such as fever and body aches. Option A) Engorgement is incorrect because engorgement typically occurs when the breasts become overly full with milk, leading to swelling and discomfort, but it is not directly related to retained placental fragments causing an infection. Option C) Blocked milk duct is incorrect as it occurs when milk is unable to flow freely within the duct, often due to pressure on the duct, but it is not specifically associated with an infection caused by retained placental fragments. Option D) Low milk supply is incorrect in this context because retained placental fragments leading to mastitis would not directly impact milk production. Low milk supply can be influenced by various factors such as inadequate breastfeeding or hormonal issues, but it is not the expected complication in this scenario. Educationally, understanding the potential complications of retained placental fragments in breastfeeding women is crucial for nurses and healthcare providers to provide appropriate care and support. Recognizing the signs and symptoms of mastitis, differentiating it from other breastfeeding issues, and initiating prompt treatment are essential in ensuring the well-being of both the mother and the infant. This knowledge helps in promoting successful breastfeeding outcomes and maternal health postpartum.

Correct Answer: B

Rationale: In the context of postpartum hormonal changes, understanding different types of placentas and their implications is crucial for providing optimal care to postpartum clients. In this scenario, the correct answer is B) Succenturiate placenta. The succenturiate placenta is characterized by accessory lobes connected to the main placental mass by blood vessels. This condition can lead to complications such as retained placental tissue, postpartum hemorrhage, and increased risk of placental abnormalities in future pregnancies. Therefore, it is important for the nurse to accurately identify and document this type of placenta for appropriate monitoring and management. Now, let's discuss why the other options are incorrect: A) Circumvallate placenta: This refers to a placenta with a thickened ring-like edge, which can also lead to complications but is not depicted in the image provided. C) Placenta with velamentous cord insertion: This refers to a condition where the umbilical cord inserts into the fetal membranes before reaching the placenta, which is not the case in the image. D) Battledore placenta: This refers to a condition where the umbilical cord inserts at the edge of the placenta, resembling a tennis racket handle, which is not depicted in the image. Educationally, this question reinforces the importance of visual recognition and accurate documentation of placental variations to guide postpartum care. It highlights the significance of understanding placental anatomy in assessing postpartum risks and complications, thereby enhancing the nurse's ability to provide safe and effective care to postpartum clients.